Sociocultural Factors Affecting the Prevalence and Control of Lymphatic Filariasis in Lau Local Government Area,Taraba State

Abstract

The Health Belief Model (HBM) and the Structural Basis for Health Action theories were employed in assessing the factors associated with the prevalence of lymphatic filariasis (LF) and the feasibility of a control program using a mass chemotherapy approach, in Lau Local Government Area of Taraba State, Nigeria. Two communities with health facilities and one without a health facility were studied in 2003. A modified version of the WHO cluster sampling technique was used in the random selection of respondents. Clinical examination, questionnaire survey, focus group discussion and key informant interview techniques were used in collecting the data. LF, involving elephantiasis and hydrocoele, is perceived as a severe disease in the communities, being ranked the 2nd and 3rd most severe respectively among the ten most common diseases in the communities. However a low perception of personal susceptibility to LF was identified among the people. The study also found serious gaps in understanding between knowledge of the cause of the disease and the means of its transmission. Very few people associated LF with mosquito bites. The treatments available and used by the people are predominantly traditional (scarifications and application of herbal preparations). Effective alternatives provided by the health system were lacking, even though about 97% of the people indicated willingness to take part in a mass chemotherapy program for the control of the disease. The two theories were useful in explaining the widespread prevalence of LF in the community and in understanding the health behavior of the people faced with the challenge of such a debilitating and stigmatizing disease. The health system has failed to provide an effective program to eliminate the disease. In the absence of a control or elimination program for LF, the people make use of traditional treatments both because of limited knowledge with regard to LF and the lack of effective care for those already affected and not because of lack of belief in the efficacy of modern treatment.

Get full access to this article

View all access options for this article.

References

Addis

. Lymphatic Filariasis, Bull. WHO, 76(Supp 2), pp. 145–146, 1988.

Nord

. Methods for Quality Adjustment of Life Years, Social Science and Medicine, 34(5), pp. 559–569, 1992.

World Health Organization (WHO). Lymphatic Filariasis Infection and Disease Control Strategies. Report of A WHO consultative meeting held at the Universite Sains Malaysia, Penang, Malaysia. Document TDR/CTD/PENENG/94.1, Geneva, WHO, 1994.

World Bank. Investing in Health, World Development Report, Oxford University Press, New York, 1993.

Evans

D. B.

Gelband

, and Vlassoff

. Social and Economic Factors and the Control of Lymphatic Filariasis: A Review, Acta Tropica, 53, pp. 1–26, 1993.

Gyapong

J. O.

Adjei

Vlassoff

, and Weiss

. Filariasis in Northern Ghana: Some Cultural Beliefs and Practices and Their Implications for Disease Control, Social Science and Medicine, 43(4), pp. 235–242, 1996a.

Coriel

Maynard

Louis-Charles

, and Addis

. Filarial Elephantiasis among Haitian Women: Social Context and Behavioural Factors in Treatment, Tropical Medicine and Internal Health, 3(6), pp. 467–473, 1998.

Anonymous. Recommendations of the International Task Force for Disease Eradication, Morbidity and Mortality Weekly Reports, 42, pp. 1–38, 1993.

Casely-Smith

J. R.

. Modern Treatment of Lymphatic Edema-Complex Physical Therapy: The First 200 Australia Limbs, Australasian Journal of Dermatology, 33, pp. 61–68, 1992.

10.

Boris

Weindorf

Lasinski

, and Boris

. Lymphoedema Reduction by Noninvasive Complex Lymphoedema Therapy, Oncology, 8, pp. 95–106, 1994.

11.

Eberhard

M. L.

Walker

E. M.

Addis

D. G.

, and Lammie

P. J.

. A Survey of Knowledge, Attitudes, and Perceptions (KAPs) of Lymphatic Filariasis, Elephantiasis, and Hydrocoele among Residents in an Endemic Area in Haiti, American Journal of Tropical Medicine and Hygiene, 54, pp. 299–303, 1996.

12.

Amazigo

U. V.

Obono

O. M.

Dadzie

K. Y.

Remme

Jiya

Ndyomugyenyi

Roungou

J. B.

Noma

, and Sékétéli

, Monitoring Community-Directed Treatment Programmes for Sustainability: Lessons from the African Programme for Onchocerciasis Control (APOC). Annals of Tropical Medicine and Parasitology, 96(Suppl 1), pp. S75–S92, 2002.

13.

Okeibunor

J. C.

Ogungbemi

M. K.

Sama

Gbeleou

S. C.

Oyene

, and Remme

J. H. F.

. Additional Health and Development Activities for Community-Directed Distributors of Ivermectin: Threat or Opportunity for Onchocerciasis Control?, Tropical Medicine and International Health, 9(9), pp. 1–10, 2004.

14.

Godin

G. D.

, and Shepard

R. J.

. Physical Fitness Promotion Programmes: Effectiveness in Modifying Exercise Behaviour, Canadian Journal of Applied Sports Service, 8, pp. 104–113, 1983.

15.

Akogun

O. B.

. Research Seminar on Community Self-Managed Lymphoedema Treatment in Northeastern Nigeria, Presentation of findings of a TDR/WHO-funded project (ID A00560) on Lymphoedema Treatment, Yola, Adamawa State, Nigeria, August 21–23, 2002.

16.

Akogun

O. B.

, and Onwuliri

. Hyperendemic Onchocerciasis in the Taraba Valley of Gongola State (Old Adamawa province), Nigeria, Annals of Parasitology and Human Comp., 66(1), pp. 22–26, 1991.

17.

Akogun

O. B.

. The Incidence of Mansonellosis and Loiasis in the Taraba Valley, Annals of Borno, 11/12, pp. 147–153, 1994–95.

18.

National Population Commission. Nigerian 1991 Population Census: Projection for 2002, Abuja, NPC, 2002.

19.

Lucas

A. O.

, and Gilles

H. M.

. Short Textbook of Public Health Medicine for the Tropics (4th Ed.), Arnold, London, 2003.

20.

Russel

B. H.

. Research Methods in Anthropology: Qualitative and Quantitative Approaches (2nd Ed.), Alta Mira Press, CA, USA, 1995.

21.

Gyapong

J. O.

Webber

R. H.

Morris

, and Bennett

. The Use of Hydrocoele Prevalence as a Rapid Diagnosis Index for Lymphatic Filariasis Infection, Transactions of the Royal Society of Tropical Medicine and Hygiene, 92, pp. 40–43, 1998.

22.

Lasker

. Choosing among Therapies: Illness Behaviour in the Ivory Coast, Social Science and Medicine, 15A, pp. 157–168, 1981.

23.

Hunter

J. M.

. Elephantiasis: A Disease of Development in Northeast Ghana, Social Science and Medicine, 35(5), pp. 627–645, 1992.

24.

Rosenstock

I. M.

. Historical Origins of the Health Belief Model, Health Education Monographs, 2, p. 328, 1974.

25.

Ahorlu

C. K.

Dunyo

S. K.

Koram

K. A.

Nkruma

F. K.

Aagaard-Hansen

, and Simonsen

P. E.

. Lymphatic Filariasis Related Perceptions and Practices on the Coast of Ghana: Implications for Prevention and Control, Acta Tropica, 73, pp. 251–264, 1999.

26.

Gyapong

J. O.

Weiss

, and Tanner

. The Burden of Hydrocoele on Men in Northern Ghana, Acta Tropica, 77(3), pp. 287–294, 2000.

27.

Ramaiah

K. D.

Kumar

Vijay K. N.

Chandrakala

A. V.

Augustin

D. J.

Appavoo

N. C.

, and Das

P. K.

. Effectiveness of Community and Health Services—Organized Drug Delivery Strategies for the Elimination of Lymphatic Filariasis in Rural Areas of Tamil Nadu, India, Tropical Medicine and International Health, 6(12), pp. 1062–1069, 2000.

28.

Gyapong

J. O.

, and Owusu-Banahene

. Community-Directed Treatment: The Way Forward to Eliminating Lymphatic Filariasis as a Public-Health Problem in Ghana, Annals of Tropical Medicine and Parasitology, 95(1), pp. 77–96, 2001.

29.

Gyapong

J. O.

Gyapong

Evans

D. B.

Aikins

M. K.

, and Adjei

. The Economic Burden of Lymphatic Filariasis in Northern Ghana, Annals of Tropical Medicine and Parasitology, 90(1), pp. 39–48, 1996.

30.

Dunyo

S. K.

Nkrumah

F. K.

, and Simonsen

P. E.

. A Randomized Double-Blind Placebo-Controlled Field Trial of Ivermectin and Albendazole Alone and in Combination for the Treatment of Lymphatic Filariasis in Ghana, Transactions of the Royal Society of Tropical Medicine and Hygiene, 94, pp. 205–211, 2000a.

31.

Dunyo

S. K.

Nkrumah

F. K.

, and Simonsen

P. E.

. Single-Dose Treatment of Wuchereria Bancrofti Infections with Ivermectin and Albendazole Alone or In Combination: Evaluation of the Potential for Control at 12 Months After Treatment, Transactions of the Royal Society of Tropical Medicine and Hygiene, 94, pp. 437–443, 2000b.

32.

Ottesen

E. A.

. The Global Programme to Eliminate Lymphatic Filariasis, Tropical Medicine and International Health, 5(9), pp. 591–594, 2000.